Provider Demographics
NPI:1669423042
Name:ROSENBERG, ROBERT E (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 N CENTRAL AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1832
Mailing Address - Country:US
Mailing Address - Phone:914-271-4727
Mailing Address - Fax:914-271-5639
Practice Address - Street 1:280 N CENTRAL AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1832
Practice Address - Country:US
Practice Address - Phone:914-271-5639
Practice Address - Fax:914-271-5639
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0515652080B0002X
NY1799212080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02223009Medicaid